Rocal-D
Generic Name
Calcium Carbonate (Elemental Calcium 500 mg) + Vitamin D3 (Cholecalciferol)
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| rocal d 500 mg tablet | ৳ 8.00 | ৳ 80.00 |
Description
Overview of the medicine
Rocal-D 500 mg Tablet is a combination supplement of Calcium and Vitamin D3, primarily used to maintain bone health and treat or prevent calcium and vitamin D deficiencies. It plays a crucial role in bone formation, density, and overall metabolic functions.
Uses & Indications
Dosage
Adults
Typically 1-2 tablets daily, or as directed by a physician. The dose should be adjusted based on individual calcium and vitamin D needs.
Elderly
Same as adults, but may require closer monitoring of calcium levels due to potential age-related changes in renal function.
Renal_impairment
Use with caution. Dosage adjustment may be necessary based on the degree of renal impairment and serum calcium levels. Consult a physician.
How to Take
Rocal-D tablets should be swallowed whole with water, with or without food. For best absorption, it is often recommended to take calcium with meals.
Mechanism of Action
Calcium is an essential mineral for strong bones and teeth, nerve transmission, muscle contraction, and blood clotting. Vitamin D3 (Cholecalciferol) facilitates the absorption of calcium from the gut, maintains proper calcium and phosphate levels in the body, and supports bone mineralization. It also plays a role in immune function.
Pharmacokinetics
Onset
Therapeutic effects on bone mineral density are gradual and require long-term supplementation. Initial biochemical changes may be observed sooner.
Excretion
Unabsorbed calcium is excreted in feces; absorbed calcium is excreted primarily via urine, with some biliary excretion. Vitamin D metabolites are primarily excreted in bile and feces, with some renal excretion.
Half life
Elemental calcium has complex pharmacokinetics; Vitamin D3 (cholecalciferol) has a half-life of approximately 15-20 days, but its active metabolite (calcitriol) has a shorter half-life.
Absorption
Calcium absorption from the gastrointestinal tract is variable and dependent on factors like dietary intake and vitamin D status. Vitamin D3 is well-absorbed orally, primarily from the small intestine.
Metabolism
Calcium is not metabolized in the traditional sense. Vitamin D3 is hydroxylated in the liver to 25-hydroxyvitamin D (calcifediol) and then in the kidneys to the active form, 1,25-dihydroxyvitamin D (calcitriol).
Side Effects
Contraindications
- Hypersensitivity to the active substances or any of the excipients
- Hypercalcemia (high levels of calcium in the blood)
- Hypercalciuria (high levels of calcium in the urine)
- Severe renal impairment
- Kidney stones (nephrolithiasis/nephrocalcinosis)
Drug Interactions
Thiazide diuretics
May increase the risk of hypercalcemia by reducing calcium excretion.
Cardiac glycosides (e.g., Digoxin)
Hypercalcemia may potentiate the toxic effects of cardiac glycosides.
Bisphosphonates (e.g., Alendronate)
Calcium can reduce the absorption of bisphosphonates. Administer at least 30-60 minutes apart.
Thyroid hormones (e.g., Levothyroxine)
Calcium can impair the absorption of thyroid hormones. Administer at least 4 hours apart.
Tetracycline and Fluoroquinolone antibiotics
Calcium can chelate these antibiotics, reducing their absorption. Administer at least 2-3 hours apart.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include hypercalcemia (nausea, vomiting, constipation, abdominal pain, muscle weakness, polyuria, polydipsia, confusion, in severe cases cardiac arrhythmias and coma). Management involves discontinuing the supplement, ensuring adequate hydration, and symptomatic treatment. In severe cases, intravenous fluids, diuretics, and calcitonin may be used.
Pregnancy & Lactation
Calcium and Vitamin D are essential during pregnancy and lactation. Rocal-D can be used during these periods under medical supervision to ensure appropriate dosage and avoid excessive intake, which could be harmful.
Side Effects
Contraindications
- Hypersensitivity to the active substances or any of the excipients
- Hypercalcemia (high levels of calcium in the blood)
- Hypercalciuria (high levels of calcium in the urine)
- Severe renal impairment
- Kidney stones (nephrolithiasis/nephrocalcinosis)
Drug Interactions
Thiazide diuretics
May increase the risk of hypercalcemia by reducing calcium excretion.
Cardiac glycosides (e.g., Digoxin)
Hypercalcemia may potentiate the toxic effects of cardiac glycosides.
Bisphosphonates (e.g., Alendronate)
Calcium can reduce the absorption of bisphosphonates. Administer at least 30-60 minutes apart.
Thyroid hormones (e.g., Levothyroxine)
Calcium can impair the absorption of thyroid hormones. Administer at least 4 hours apart.
Tetracycline and Fluoroquinolone antibiotics
Calcium can chelate these antibiotics, reducing their absorption. Administer at least 2-3 hours apart.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include hypercalcemia (nausea, vomiting, constipation, abdominal pain, muscle weakness, polyuria, polydipsia, confusion, in severe cases cardiac arrhythmias and coma). Management involves discontinuing the supplement, ensuring adequate hydration, and symptomatic treatment. In severe cases, intravenous fluids, diuretics, and calcitonin may be used.
Pregnancy & Lactation
Calcium and Vitamin D are essential during pregnancy and lactation. Rocal-D can be used during these periods under medical supervision to ensure appropriate dosage and avoid excessive intake, which could be harmful.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 2-3 years from the date of manufacture, refer to the product packaging for exact expiry.
Availability
Available in pharmacies and supermarkets
Approval Status
Approved
Patent Status
Generic / Patent Expired
Clinical Trials
Numerous clinical trials and studies support the efficacy and safety of calcium and vitamin D supplementation for bone health and deficiency states. Specific brand-level trials might vary, but the generic components are well-studied.
Lab Monitoring
- Serum calcium levels (especially in patients on high doses, with renal impairment, or on long-term therapy)
- Renal function (e.g., serum creatinine, eGFR)
Doctor Notes
- Advise patients to report symptoms of hypercalcemia (e.g., persistent nausea, vomiting, unusual fatigue).
- Consider baseline and periodic monitoring of serum calcium and renal function, especially in elderly patients, those with pre-existing renal impairment, or on concomitant medications that affect calcium metabolism.
- Emphasize that this is a supplement, not a substitute for a balanced diet.
Patient Guidelines
- Do not exceed the recommended daily dose unless advised by a physician.
- Ensure adequate fluid intake to prevent constipation and reduce the risk of kidney stones.
- Inform your doctor about all other medications and supplements you are taking.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Rocal-D is not known to affect the ability to drive or operate machinery.
Lifestyle Advice
- Maintain a balanced diet rich in calcium and vitamin D.
- Engage in regular weight-bearing exercise to support bone health.
- Avoid smoking and excessive alcohol consumption, which can negatively impact bone density.
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